Reproductive technology has expanded and improved immensely over the years. The accessibility of assisted reproduction, fertility treatments, and even adoption, though, is highly limited, particularly in the United States. All of these processes can be prohibitively expensive, and, often, insurance does not cover them or organizations can arbitrarily choose not to provide them.

As reproductive technology is largely unregulated in the U.S., private organizations that manage processes such as embryo donations have full discretion when choosing who can participate in their programs. The National Embryo Donation Center (NEDC) states in its policies that they will only provide embryos to heterosexual, married couples, for example. The NEDC is founded in the Judeo-Christian worldview, and they explicitly exercise this viewpoint--or their perspective of it, at least--when selecting eligible couples for their services.

Jeffrey Keenan, the NEDC's medical director, says that their policy is to operate based on the "biological reality" of a family and God's intention for conception.

As much as you see gay people having children, you have noticed that none of them do it on their own. It is physically and scientifically impossible for gay people to have a child. So why just because we can have someone act as a surrogate, or because we can donate into a [gay] woman, why does that make it right? It doesn’t, not in and of itself.

Civil rights communities, LGBT groups, and, increasingly, the courts oppose these views. What many consider illegal discrimination, though, endures under the protection of U.S. law since such procedures are not generally considered "medically necessary."

Basic fertility treatments are rarely covered by U.S. insurance policies, and when they are, the insurance company may first require proof and documentation of a medical reason preventing "natural" pregnancy.

This is not the case in many other developed countries, where formal regulations, ethical requirements, and even entire administrative departments preside over reproductive technology. The United Kingdom's Human Fertilisation and Embryology Authority, for example, is solely committed to the regulation of fertility treatments and embryonic research in the U.K.

In the U.S., there is simply "no equality of access" to reproducing, says Antonio Gargiulo, an obstetrician-gynecologist and director of robotic surgery at the Brigham and Women's Hospital in Boston. As it stands, Boston residents do have access to fertility treatments under insurance, though; Massachusetts was the first state to pass laws requiring treatments be covered by insurance back in 1987. Just last year, New York also began requiring insurance companies to provide infertility treatments to those seeking, including homosexual couples and single women.

Many medical professionals, though, are skeptical that the federal government--particularly under the anti-regulation Trump administration--will make any moves toward ensuring fertility treatments and reproductive technology are uniformly covered by insurance and accessible to all Americans.